Swallowing Dysfunction and Autonomic Nervous System Dysfunction in Alzheimer's Disease: A Scoping Review of the Evidence

Affoo, Rebecca; Foley, Norine; Rosenbek, John C.; Shoemaker, J. Kevin; Martin, Ruth Elwood

doi:10.1111/jgs.12553

Cited by 94 publications

(73 citation statements)

References 45 publications

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“…Such pneumonic changes are also described in human patients with neurodegenerative disorders like Parkinson's or Alzheimer's disease or stroke. It was supposed that aspiration pneumonia of these patients was the result of swallowing disturbances, which may be due to autonomic nervous system dysfunction (Kim et al 2000;Affoo et al 2013;Cereda et al 2014). This feature seems to be of special interest for the present study because dt-MP mice showed widespread neurodegenerative lesions in the brain stem, including nuclei important for the oral and pharyngeal phase of the swallowing process, namely the trigeminal nuclei and the pontine reticular formation (Lang 2009).…”

Section: Discussionmentioning

confidence: 92%

Axonopathy in the Central Nervous System Is the Hallmark of Mice with a Novel Intragenic Null Mutation of Dystonin

et al. 2016

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Dystonia musculorum is a neurodegenerative disorder caused by a mutation in the dystonin gene. It has been described in mice and humans where it is called hereditary sensory autonomic neuropathy. Mutated mice show severe movement disorders and die at the age of 3-4 weeks. This study describes the discovery and molecular, clinical, as well as pathological characterization of a new spontaneously occurring mutation in the dystonin gene in C57BL/6N mice. The mutation represents a 40-kb intragenic deletion allele of the dystonin gene on chromosome 1 with exactly defined deletion borders. It was demonstrated by Western blot, mass spectrometry, and immunohistology that mice with a homozygous mutation were entirely devoid of the dystonin protein. Pathomorphological lesions were restricted to the brain stem and spinal cord and consisted of swollen, argyrophilic axons and dilated myelin sheaths in the white matter and, less frequently, total chromatolysis of neurons in the gray matter. Axonal damage was detected by amyloid precursor protein and nonphosphorylated neurofilament immunohistology. Axonopathy in the central nervous system (CNS) represents the hallmark of this disease. Mice with the dystonin mutation also showed suppurative inflammation in the respiratory tract, presumably due to brain stem lesion-associated food aspiration, whereas skeletal muscles showed no pathomorphological changes. This study describes a novel mutation in the dystonin gene in mice leading to axonopathy in the CNS. In further studies, this model may provide new insights into the pathogenesis of neurodegenerative diseases and may elucidate the complex interactions of dystonin with various other cellular proteins especially in the CNS. KEYWORDS axonopathy; dystonia musculorum; dystonin deficiency; genomic deletion; spontaneous mutation A spontaneously occurring mutant was described in the mouse, in which the gene dystonin was affected (Ledoux 2011). Dystonin (Dst) [human gene name, DST; former name, bullous pemphigoid antigen 1 (BPAG1)] is a large cytoskeletal linker protein and crucial for maintaining cellular structural integrity (Young and Kothary 2008). Recent research in this field concentrates on the role of dystonin in central nervous tissue and neurological diseases, but not, however, on its parallel expression in musculature and skin.Mice with a mutated dystonin gene develop a severe sensory neuropathy called dystonia musculorum (Duchen 1976). Characteristics are a progressive loss of coordination of the limbs (ataxia) and an early death (Kothary et al. 1988;Guo et al. 1995). There are only few reports about patients with mutations of the human dystonin gene (Giorda et al. 2004;Groves et al. 2010;Edvardson et al. 2012).Several dystonin isoforms are generated from one genomic locus of 400 kb. They are expressed in the central nervous system (CNS) (predominant neuronal isoform "a," 617 kDa and "n," 344 kDa), muscles (predominant muscle isoform "b," 834 kDa), and skin (predominant skin isoform "e," 302 kDa) ( Figure 1 Pool et al...

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Section: Discussionmentioning

confidence: 92%

Axonopathy in the Central Nervous System Is the Hallmark of Mice with a Novel Intragenic Null Mutation of Dystonin

et al. 2016

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“…Scoping reviews are literary searches that are used to provide a preliminary assessment of the size and scope of a body of literature as well as identify strengths, weaknesses and gaps in the research 18 19. Scoping reviews have been used to summarise bodies of literature on concussion rehabilitation strategies20 and on other health-related issues like Alzheimer's disease,21 HIV rehabilitation22 and in settings such as trauma centres23 and intensive care facilities 24. Because research on concussion education programmes is relatively new, a scoping review is ideal to determine the state of these education programmes.…”

Section: Introductionmentioning

confidence: 99%

An examination of concussion education programmes: a scoping review methodology

et al. 2015

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ObjectivesThe primary purpose was to review the literature on concussion education programmes. The secondary purpose was to inform knowledge translation strategies for concussion researchers and practitioners. Design Research on concussion education programmes is relatively new. As a result, the current study implemented a scoping review methodology, which is a type of literary search used to provide a preliminary assessment of the size and scope of a body of literature, as well as identify strengths, weaknesses and gaps in the research. Methods A five-stage process for conducting a scoping review was followed for this study: (a) identifying the research questions, (b) identifying relevant studies, (c) identifying the study selection criteria, (d) charting the data and (e) reporting the results. Results Concussion education programmes have been developed and implemented with populations ranging in age from 9 to 49 years and have used interactive oral presentations, educational videos and computer-based learning programmes. Although the content of these programmes varied, the topics generally addressed salient aspects of concussion injury and recovery. Quantitative instruments have been the preferred methods for assessment. Conclusions Education programmes aimed at improving participants' long-term concussion knowledge, behaviours and attitudes of concussions are needed. Researchers must consider using a knowledge translation framework to enhance concussion education programmes. The application of such a framework can lead to novel and interesting ways of disseminating information about concussive injury and recovery.

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“…Sin embargo, no existe un consenso en cuanto a su idoneidad de uso según el caso (2). Un test que sí se ha demostrado útil en la clínica es el método de exploración clínica Volumen-Viscosidad (MECV-V) (1,4,11,23,29,33,36,37), empleado para detectar las posibles aspiraciones silentes y basado en la observación de las reacciones de tos, asfixia y alteración de voz (32,37) (Fig.…”

Section: Diagnóstico De La Disfagia Y Prevención De Complicacionesunclassified

“…Es un proceso neuromuscular complejo, requiere coordinación muy precisa e implica una secuencia de acontecimientos que permiten la progresión del bolo, transportándolo desde la vía aérea (1). El objetivo de la deglución es la nutrición del individuo, teniendo dos características fundamentales: la eficacia de la deglución, refiriéndose a la posibilidad de ingerir la totalidad de las calorías y el agua necesarios para mantener una adecuada nutrición e hidratación; y la seguridad de la deglución, siendo esta la posibilidad de ingerir el agua y las calorías necesarias sin que se produzcan complicaciones respiratorias (2).…”

Section: Introductionunclassified

“…La disfagia corresponde a un "trastorno para tragar alimentos sólidos, semisólidos y/o líquidos por una deficiencia en cualquiera de las cuatro etapas de la deglución" que puede desencadenar complicaciones como desnutrición, deshidratación, obstrucción de la vía aérea y neumonía (2). La disfagia presente en enfermos de alzhéimer se denomina disfagia neurógena y la importancia de poder identificarla precozmente radica en que es un síntoma grave, con complicaciones que pueden causar la muerte del paciente y aparecer tanto en el periodo agudo del proceso como en el subagudo o crónico, y tanto de manera aislada como formando parte de un grupo sindrómico (1,3).…”

Section: Introductionunclassified

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Abordaje de la disfagia en enfermos de alzhéimer

González

Molina-Recio

2016

Nutr Hosp

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Palabras clave:Alzheimer. Disfagia. Multidisciplinar. Revisión sistemática. Key words:Alzheimer. Dysphagia. Multidisciplinary. Systematic review. AbstractIntroduction: Dysphagia is a symptom that refers to the inability to move the bolus from the mouth to the stomach. Despite its importance and the severity of possible complications it is relatively little known and studied. The prevalence of oropharyngeal dysphagia in Alzheimer patients is up to 84% and it may cause complications with great clinical signifi cance due to alterations in swallowing effi ciency and security. Aim: To know the current state of knowledge regarding the integrated approach of dysphagia in Alzheimer patients, fi nding the factors that enable an early diagnosis to facilitate the prevention of complications and to choose the pattern most appropriate action. Methodology: Systematic review of papers published English and Spanish between 2005 and 2014. Databases consulted: PubMed, Cochrane, Scopus, Elsevier, Scielo and Dialnet. Mesh terms used: disfagia, dysphagia, alzheimer, and texture modifi ed food. Results: The diagnosis of dysphagia in Alzheimer patients is performed using clinical methods and complementary examinations such as videofl uoroscopy, considered to be the gold standard for the study of oropharyngeal dysphagia, detecting from 1/3 to 1/4 of the cases, who could present no diagnosable clinically silent aspiration. There are therapeutic strategies that include changes in bolus volume and viscosity, postural changes, deglutition maneuvers, rehabilitation procedures and increase sensory techniques that have proved effective, but it is a complex task that requires a multidisciplinary approach for a correct diagnosis and treatment to improve the quality of life of these patients. Conclusions: There is a lack of scientifi c evidence in addressing dysphagia and of knowledge about the feeding and nutrition of these patients. This condition requires a multidisciplinary intervention where dietary measures play a major role.

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Swallowing Dysfunction and Autonomic Nervous System Dysfunction in Alzheimer's Disease: A Scoping Review of the Evidence

Cited by 94 publications

References 45 publications

Axonopathy in the Central Nervous System Is the Hallmark of Mice with a Novel Intragenic Null Mutation of Dystonin

Axonopathy in the Central Nervous System Is the Hallmark of Mice with a Novel Intragenic Null Mutation of Dystonin

An examination of concussion education programmes: a scoping review methodology

Abordaje de la disfagia en enfermos de alzhéimer

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